Future of your Business, Family and Wider World by Dr Patrick Dixon, Futurist Speaker, Keynotes on Growth Strategies and Leadership, Lecture Slides, Articles and Videos from Conferences - 15 million unique visitors to MAIN Futurist site (articles / keynotes / videos) - link on right to www.globalchange.com

Every week there are new claims being made about embryonic stem cells and adult stem cells, what is the truth? Here is a brief summary of important stem cell trends. You will also find on this site keynote presentations on stem cell research, speeches and powerpoint slides on the future of health care, the future of medicine, the future of the pharmaceutical industry, and the future of ageing - all of which are profoundly impacted by stem cell research.

There is no doubt that we are on the edge of a major stem cell breakthrough. Stem cells will one day provide effective low-cost treatment for diabetes, some forms of blindness, heart attack, stroke, spinal cord damage and many other health problems. Animal stem cell studies are already very promising and some clinical trials using stem cells have started (article written in September 2004).

As a physician and a futurist I have been monitoring the future of stem cells for over two decades, and advise corporations on these issues. Stem cell investment, research effort, and treatment focus is moving rapidly away from embryonic stem cells (ethical and technical challenges) to adult stem cells which are turning out to be far easier to convert into different tissues than we thought in 2000-2003.

I have met a number of leading researchers, and their progress in stem cell research is now astonishing, while over 2,000 new research papers on embryonic or adult stem cells are published in reputable scientific journals every year.

Stem cell technology is developing so fast that many stem cell scientists are unaware of important progress by others in their own or closely related fields. They are unable to keep up. The most interesting work is often unpublished, or waiting to be published. There is also of course commercial and reputational rivalry, which can on occaisions tempt scientists to downplay the significance of other people's results (or their claims)..

What exactly are stem cells? Will stem cells deliver? Should you invest in biotech companies that are developing stem cell technology? What should physicians, health care professionals, planners and health departments expect? What will be the impact of stem cell treatments on the pharmaceutical industry? How expensive will stem cell treatments be? What about the ban on embryonic stem cell research in many nations? Do embryonic stem cell treatments have a future or will they be overtaken by adult stem cell technology?

What are stem cells - embryonic and adult stem cells

Stem cells are relatively primitive cells that have the ability to divide rapidly to produce more specialized cells. Stem cells in the embryo are capable of huge variation in the kinds of tissues they make, reproduce rapidly and have attracted interest of researchers for decades. However embryonic stem cells are hard to get hold of in humans - you need a supply of human embryos, which requires either breaking the law in some countries or applying for complex licenses in others.

Embryonic stem cells are also hard to control, and hard to grow in a reliable way. They have "minds" of their own, and embryonic stem cells are often unstable, producing unexpected results as they divide, or even cancerous growths. Human embryonic stem cells usually cause an immune reaction when transplanted into people, which means cells used in treatment may be rapidly destroyed unless they are protected, perhaps by giving medication to suppress the immune system (which carries risks).

One reason for intense interest in human cloning technology is so-called therapeutic cloning. This involves combining an adult human cell with a human egg from which the nucleus has been removed. The result is a human embryo which is dividing rapidly to try and become an identical twin of the cloned adult. If implanted in the womb, such cloned embryos have the potential to be born normally as cloned babies, although there are many problems to overcome, including catastrophic malformations and premature ageing as seen in animals such as Dolly the sheep.

In theory, therapeutic cloning could allow scientists to take embryonic stem cells from the cloned embryo, throw the rest of the embryo away and use the stem cells to generate new tissue which is genetically identical to the person cloned. In practice this is a very expensive approach fraught with technical challenges as well as ethical questions and legal challenges.

An alternative is to try to create a vast tissue bank of tens of thousands of embryonic cells lines, by extracting stem cells from so many different human embryos that whoever needs treatment can be closely matched with the tissue type of an existing cell line. But even if this is achieved, problems of control and cancer remain. And again there are many ethical considerations with any science that uses human embryos, each of which is an early developing but complete potential human being, which is why so many countries have banned this work.

The alternative to using embryonic stem cells

Until recently it was taught in all medical schools that cells in the embryo were multipotent - able to give rise to every tissue - but by birth, this capacity was permanently lost. That has been the reason why almost all research effort focused on embryonic stem cells until just a few years ago.

However a moment's thought tells us how illogical such a view was, and indeed we are now finding that many cells in children and adults have extraordinary capacity to generate or stimulate growth of a wide variety of tissues, if encouraged in the right way.

Take for example the work of Professor Jonathan Slack at Bath University who has shown how adult human liver cells can be transformed relatively easily into insulin producing cells such as those found in the pancreas, or the work of others using bone marrow cells to repair brain and spinal cord injuries in mice and rats, and now doing the same to repair heart muscle in humans.

Why should this surprise us? We know that almost all cells in your body contain your entire genome or book of life: enough information to make an entire copy of you, which is the basis of cloning technology. So in theory just about every cell can make any tissue you need. However the reality is that in most cells almost every gene you have is turned off - but as it turns out, not as permanently as we thought.

If we take one of your skin cells and fuse it with an unfertilized human egg, the chemical bath inside a human egg activates all the silenced genes, and the combined cell becomes so totipotent that it starts to make a new human being.

What then if we could find a way to reactivate just a few silenced genes, and perhaps at the same time silence some of the others? Could we find a chemical that would mimic what happens in the embryo, with the power to transform cells from one type into another? Yes we can. Jonathan Slack and others have done just that. What was considered impossible five years ago is already history.

Could we take adult cells and force them back into a more general, undetermined embryonic state? Yes we can. It is now possible to create cells with a wide range of plasticity, all from adult tissue. The secret is to get the right gene activators into the nucleus, not so hard as we thought.

Impact of embryonic and adult stem cells on the future of medicine and health care

Stem cell therapy is not a conventional treatment using an external agent and so the normal 15 year development pipeline for new pharmaceutical products does not apply. Indeed the gap between seeing promising stem cell results in animals and starting first human trials can be as short as 15 days.

Suppose you have a heart attack. A cardiothoracic surgeon talks to you about using your own stem cells in an experimental treatment. You agree. A sample of bone marrow is taken from your hips, and processed using standard equipment found in most oncology centers for treating leukemia. The result is a concentrated number of special bone marrow cells, which are then injected back into your own body - either into a vein in your arm, or perhaps direct into the heart itself.

The surgeon is returning your own unaltered stem cells back to you, to whom these cells legally belong. This is not a new molecule requiring years of animal and clinical tests. Your own adult stem cells are available right now. No factory is involved - nor any pharmaceutical company sales team.

What is more, there are no ethical questions (unlike embryonic stem cells), no risk of tissue rejection, no risk of cancer.

Now we begin to see why research funds are moving so fast from embryonic stem cells to adult alternatives.

Harvard Medical School is another center of astonishing progress in adult stem cells. Trials have shown partially restored sight in animals with retinal damage. Clinical trials are expected within five years, using adult stem cells as a treatment to cure blindness caused by macular degeneration - old-age blindness and the commonest cause of sight-loss in America. Within 10 years it is hoped that people will be able to be treated routinely with their own stem cells in a clinic using a two-hour process.

If you want further evidence of this switch in interest from embryonic to adult stem cells,, look at the makers of Dolly the sheep. The Rosslyn Institute in Scotland are pioneers in cloning technology. They along with others campaigned successfully in UK Parliament for the legal right to use the same technology in human embryos (therapeutic cloning, not with the aim of clones being born). But three years later, they had not even bothered to apply for a human cloning licence.

Why not? Because investors were worried about throwing money at speculative embryo research with massive ethical and reputational risks. Newcastle University made headlines in August 2004 when granted the first licence to clone human embryos - but the real story was why it had taken so long to get a single research institute in the UK to actually get on and apply. Answer: medical research moved on and left the "therapeutic" human cloners behind.

Do stem cells really repair tissue?

For several years there has been a curious and very confusing debate in editorials of publications like the New England Journal of Medicine about whether adult stem cells actually regenerate tissue or not.

The debate centers on technical questions and semantics, rather than the reality of results. Take for example heart repair. We know that bone marrow cells can land up in damaged heart and when present, the heart is repaired. It is hard to be certain what proportion of this remarkable process is due to stimulants released locally by bone marrow cells, or by the bone marrow cells actually differentiating into heart tissue.

It remains a confusing picture, not least because in the lab, cells seem to change character profoundly, but in clinical trials it appears the effects of many stem cells are stimulatory. But who cares? As a clinician I am delighted if injecting your bone marrow cells into your back means that you are walking around 3 months after a terrible injury to your spine instead of being in a wheelchair for the rest of your life. I am not so concerned with exactly how it all works, and nor will you be.

The future of stem cells

In summary, expect rapid progress in adult stem cells and slower, less intense work with embryonic stem cells. Embryonic stem cell technology is already looking rather last-century, along with therapeutic cloning. History will show that by 2020 we were already able to produce a wide range of tissues using adult stem cells, with spectacular progress in tissue building and repair. In some cases these stem cells will be actually incorporated into the new repairs as differentiated cells, in other cases, they will be temporary assistants in local repair processes.

We will also see some exciting new pharmaceutical products in the pipeline, which promise to do some of the same tricks without having to remove a single stem cell from the body. These drugs may for example activate bone marrow cells and encourage them to migrate to parts of the body where repairs are needed.

And along the way we will see a number of biotech companies fold, as a result of over-investment into embryonic stem cells, plus angst over ethics and image, without watching the radar screen closely enough, failing to see the onward march of adult stem cell technology.

Using embryos as a source of spare-part cells will always be far more controversial than using adult tissue, or perhaps cells from umbilical cord after birth, and investors will wish to reduce uneccessary risk, both to the projects they fund, and to their own organisations by association.

Despite this, we can expect embryonic stem cell research to continue in some countries, with the hope of scientific breakthroughs of various kinds.

March 16, 2004

Just returned from week in India - Calcutta, Mumbai and Goa - 2nd visit in 4 months - visiting a number of projects connected with ACET International Alliance and Oasis. Very moving and also shocking at times, yet so much can be done to save lives and give people care as well as hope, even in the most desparate situations of extreme poverty and vunerability, street projects, slum projects, girls sold as sex industry slaves and so on.

March 06, 2004

Tetrapak is a really interesing organisation. Look in your fridge. Chances are that any cartons of liquid (fruit juice or milk) were made by them (look underneath).

For their 50th anniversary the family who started it, invited hundreds of clients onto a cruise ship for several days in the mediterranean. I opened the first day with a keynote in the theatre on the future - Elton John closed the day with a rock concert that evening. Watch the video, look at the slides on the future of food.

March 03, 2004

After oil, coffee is the world's greatest commodity in trade terms, and like oil, the coffee industry raises many ethical questions about environment, human rights, inequality between wealthy and poor nations. Reasons perhaps why this presentation to the European Coffee Federation created such a stir at the time and continues to draw heavy web traffic.

March 02, 2004

Corporate governance continues to be in the news. Demands on non-executive directors are growing, as well as the risk to their reputation and personal finances if things go wrong. Expect further corporate scandals and even greater attention to the roles, responsibilities and conflicts of interests of non-executive directors who often are on many different boards.

March 01, 2004

Reports in UK press today suggesting that one in seven senior civil servants are dependent on alcohol - drinking in the morning or being warned at weekends by friends that they are drinking too much. This is far higher than the general population (6% of men and 2% of women), but probably not much higher than physicians.

February 26, 2004

Pros and cons of fish farming. We need to protect falling fish stocks in the oceans, and that means farming fish, just as we have moved to farming livestock and ceased largely to feed off hunted wild animals. But there are similar concerns about intensive farming, disease, sustainability and environmental damage. These can be overcome with sound management - there is no other alternative unless the world is to remove most fish from the diet, which is unthinkable since fish are such a healthy source of protein and other dietary components such as vital oils.

Dr Panos Zavos makes yet more claims that he is routinely implanting cloned human embryos into women to try and produce cloned babies. He continues despite widespread scepticism and condemnation.

Verdict: He is only one of many people in a race to produce healthy cloned babies in front of TV cameras and success cannot be far away (indeed may have happened some time ago). Every week we see further refinements of cloning technology in animals or humans.

February 24, 2004

Keynote lecture on the future of food and drink retailing, how consumers will change behaviour, new preferences, fads and fashions. Slogans and marketing campaigns that will work. Why corporate values and image are easily damaged by scare stories in the media and what to do about it. Challenges of demographic change. Political pressures, new regulations, requirements and standards for food and drink production. Single issue activism, food safety, nutrition. Geneticall modified (GM) foods - what is the future?

February 22, 2004

UK Prime Minister Tony Blair today suggest schools should be encouraged to test pupils for drugs - a proposal I made in The Truth about Drugs as a practical measure to encourage abstinence from drug use (if used wisely and sensitively, with pupil and parent approval).

In partnership with ACET International Alliance and Operation Mobilisation, we have just authorised an additional printing of 55,000 copies of "AIDS and You" for free distribution to church leaders and project workers across Africa and Asia in countries worst hit by AIDS.

This book contains practical guidelines and information about how to start sustainable, community-based prevention and care programmes, as well as a rationale for sensitive, effective Christian action to save lives and support those affected by HIV and AIDS.

comments: Hello, I'm currently working toward an MA in Applied Anthropology at Oregon State University. We're reading a book called, Taking Sides: Health and Society and having class debates and discussion on the topics within. I am participating in a cloning debate next week and have found your Website and book incredibly helpful! I wanted to say, keep up the great work! Thank you, Carissa

February 14, 2004

books.htm: "'Futurewise' has just been published in 3rd edition (English, Estonian and Latvian - with Russian to follow soon).

Free copies of 'AIDS and You' are available now in English, Spanish and Russian, in bulk, to organisations for distribution in developing countries - from ACET International Alliance website. French, Romanian, Czech, Turkish, Portugese, Swahili, Urdu and Hindi editions will also soon be available in bulk free of charge for organisations working in Africa, Asia, Latin America and former Eastern bloc countries, due to generous partnership with OM and other organisations. A new English edition of 'The Truth about AIDS' will also be available soon on the same basis."

February 12, 2004

Korean and US scientists today claim human cloning progress - Woo Suk Hwany of Soeul National University in Korea announced that he had succesfully cloned healthy human embryos, removed embryonic stem cells and grown them in mice. Just a couple of weeks ealier, Dr Panos Zavos made another of his frequent cloning announcements about attempts he and others are making to produce healthy cloned babies. The Korean and US teams are using human cloning technology to try to create stem cell lines which can be used to study disease.

While they are opposed to the abuse of human cloning technology to produce babes, their own cloning advances are making life easier for people like Zavos. Either way, most stem cell research is shifting rapidly away from human embryo cloning and use of embryonic stem cells, to adult stem cell development. Embryonic stem cells are controversial to use (many countries have banned the work), hard to grow, hard to control (can become cancerous), are rejected in the body unless made to order for an individual by cloning, or used in an immune protected site like the brain. That's why the makers of Dolly the Sheep ran out of human cloning money and went out of business. In comparison, there is no shortage of commercial funding for adult stem cell research which is showing spectacular results in treating mice and rats with stroke, heart and spinal cord damage.

Press Association copy:

"Dr Patrick Dixon, an author and expert in the ethics of human cloning, dismissed the idea that today’s announcement marked a breakthrough.

He said: “Except in tissues like the brain, there are huge problems with rejection of these embryonic stem cells if they are introduced into adults.

“It is very difficult for them to grow properly and very difficult to control them,” he said. "The idea that this offers a real breakthrough is based on a scientific nonsense.

“But in this supposedly spectacular benefit lies a serious risk that this technology will be abused.”

He cautioned that developments in these techniques would be “handing a gift” to controversial scientists such as Dr Panos Zavos and Clonaid intent on cloning human babies.

Dr Dixon said embryonic stem cell research was being overtaken by advances using adult cells. "Human cloning technology using embryonic stem cells is very last century. We do not need it.

“It is being overtaken rapidly by the spectacular advances in tissue repair using adult stem cells taken from the person who is unwell.

“Clinical trials are already showing results in people with heart failure while animal studies have shown successful repair in brain after stroke, heart muscle, spinal cord and other tissues.”

February 10, 2004

Surveys show there's a huge crisis of motivation in most large corporations, which is why they continue to spend billions of dollars each year on motivation courses, training in motivation, meetings to boost motivation, incentives to strengthen motivation, meetings to analyse problems in workforce motivation, tools to measure motivation, mission statements and so on. Problems in recruitment, productivity and retention, problems of commitment to teams and corporate agendas.

But the motivation gap is fundamental. People are passionate - but mainly about life outside of work. Indeed the very phrase "work-life balance" tells us that most people think that work is the opposite of life. So how did we get to be in such a motivational crisis?

Motivation has moved on and left most corporations behind

One thing is clear: motivation is changing. Just look at the current obsession with work-life balance, which is now a powerful force in every corporation, number one or two career priority for the majority of executives in the US, UK and Japan. Forget the old days when ambition meant rushing up the career ladder. Today the great dual ambition is to have a satisfying job and a fulfilling personal life.

Or take the growing motivation for community action: 60% of all US workers give time each year to work for causes they passionately believe in. The average time gift is 200 hours. If each hour given by a US citizen was charged out at the average industrial wage, you would be talking about an industry as large as 4.5% of GDP or 12% of the Federal budget.

And other countries are similar, whether people are rich or poor, in Western Europe or East Africa Despite all the gloomy pundits some years back, community motivation remains very much alive. But these motivation changes are rarely reflected in corporate policy - or if they are, in a very superficial way. That's because CEOs and senior teams are still over-influenced by last-century management ideology about efficiency, bottom-line profit, shareholder value, return on equity and other motivation - killing fixations.

Management Gurus – high priests of confusion ?

You’ll find that management theory is still mainly built on two things: psycho-theories from one or two centuries ago and also case histories of organisations. Both are rooted in the past, can be based on subjective interpretations of data, and rarely concentrate on motivation. Case histories rapidly date as our world changes – just look at old business books and count the case examples of companies that now don’t even exist, or are basket cases, or riddled with recent scandal - and the old psycho-theories raise many questions. Life in the third millennium has moved on a long way from unproveable nineteenth century introspections about unconscious motives and desires.

You’ll find great business ideas formed often many decades ago about the nature of organizations, team management, excellence at work and the rest. All vital and important things without which no business can survive, but very little that grabs you by the throat when it comes to passion, commitment and motivation.

Hey – if there was, we wouldn’t all be in this mess.

Without management experts we would all be the poorer, with lower productivity, inefficient structures, bad organizations and wasted resources. However it is a historical fact that management fads come and go faster than ever – often in less than a decade - leaving tens of thousands bruised, bashed and confused by each one that sweeps into their organization. You just have to look at a list of business titles published over the last five decades to see that. And these fads actually undermine motivation.

First are four top turn-of-the-century gurus: Peter Drucker, Tom Peters, Michael Porter and Gary Hamil. Each has had a huge impact on business thinking today but are not so strong on motivation..

Between them these giants of corporate thinking have contributed a huge amount to corporate efficiency, productivity and effectiveness, generating wealth for millions, contributing to the economy and to society.

What about passion for living?

Great leaders, great visionaries, passionate about their messages – but what do they tell us more generally about human passion for life?What do they tell us about why people act as they do? The choices they make? The things they feel strongly about? The culture we live in and the changing lifestyles choices people are making?

Of course, all of them have addressed every topic under the sun at one time or another on platforms or in writings, but what happens when you look at the main thrust of their influence?

Peter Drucker

The problem is that Drucker says everything about managing a corporation but far less that captivates the human spirit. Almost nothing about managing personal life as a whole – or about work / life balance or broader motivation issues.

Tom Peters

Tom Peters talks of excellence in companies, and also talks about passion in leadership but says almost nothing about excellence of personal quality of life, why personal commitment to workplace goals is falling and why for most people, their strongest sense of motivation is for the work they are not paid to do, the things they do outside of work, simply because they believe those things are worthwhile.

Michael Porter

Michael Porter talks of being competitive, but people are more than links in a value chain. He has a good understanding of company survival, but a relatively poor understanding of personal survival and of what people are looking for in life. Motivation is hardly at the heart of what he writes or says.

Core competency has become a widely accepted concept, encouraging corporations to focus on strengths. However, finding a company’s core competency, or even changing future corporate history does nothing to motivate me to get out of bed in the morning.

The world’s leading management gurus, on whom hundreds of thousands of management consultants base their work, are relatively silent when it comes to motivation, and are nowhere when it comes to finding one single unifying factor that drives all human action.

And we find the same when we review dozens of other widely respected gurus of management theory. Here are a few more popular buzz-words:

Actions are not the same as understanding passion that drives these actions. Strategy does not necessarily provoke personal motivation. Leadership can encourage motivation but only if it understands what makes people passionate. What's the point of a balanced team if people can’t care less? Leaders doing the right thing is often not the same as having a fired-up workforce. Passion is based on more than mere ideas. Since when did anyone at work get really get excited about a structure? Quality of products and services is hardly the core motivation for individual life, for what we do or what we buy. Re-engineering of the corporation is not the same as re-engineering people’s motivation. Objectives do not provide people with meaning and ultimate sense of purpose. Team psychology is almost irrelevant to question of personal passion and aims in life. “Company-wide quality management” is not the same as connecting with what people feel strongly about. Global branding does nothing to motivate. There is more to motivating people than having great style.

Most recognised authorities on management score low on motivation with the exception of Charles Handy, Edward Schein, Elton Mayo, Elspeth Ross Kanter, and Douglas MacGregor. And most of those who scored high are dead, or retired, and most of their works were published decades ago.

Why corporations have been given such a narrow view of motivation

Why the problem? Well one obvious reason is that he who pays the piper calls the tune and management consultants by definition are asked in by corporations to improve their bottom line profitability, not to massage the inner needs and motivation of their employees, except as a profit-enhancing exercise.

So its hardly suprising that we get on the whole a very narrow view.

One thing is clear: there is one mega black-hole of fresh thinking about motivation, about what really makes people tick, about why people act as they do.

Harness all the passions people have and they will follow you to the ends of the earth.

Conjoined twins: Conjoined Twins: Tragedy and Joy - twins with two heads and other treatment dilemmas.

Should doctors decide (or parents or lawyers in courts) whether one should die so the other conjoined twin can live? What are conjoined twins? Two heads on one baby. Moral / ethical issues and debates.

Conjoined twins (or Siamese twins) are often in the news, for example this week following the tragic death of a baby called Rebeca Martinez in the Dominican Republic, born with a two heads - joined at the skull - after doctors operated to remove the additional face, brain and other structures.

We saw another tragedy in 2000 following the arrival in the UK of distraught parents from the Maltese Island Gozo, seeking specialist surgical help to separate their two newborn babies, Jodie and Mary. Pediatric surgeons at St Mary's Hospital in Manchester had no experience of separating conjoined twins but feared that unless they acted fast, both would die. The parents were told that despite appearances, Mary's internal organs were so poorly formed that she could not survive without being joined to Jodie. The parents of the conjoined twins refused an operation, and the case was heard in court. The Judges ordered that the operation should go ahead..... but.....

What are Conjoined Twins?

Conjoined twins are formed from a single egg which develops into two almost separate balls of cells. In normal twinning, each ball becomes an identical twin. As a result cells in conjoined twins become confused about where they are in the body - indeed which of the two conjoined twins they are actually in.

In normal embryo and foetus development every cell knows where it is in the body because the neighbours produce chemical messages. So a skin cell knows not only it is skin, but that it is - say - nose skin, rather than chin or ear or lip skin. In conjoined twins these chemical messages don't work properly - how can they? The end results can be very bizarre: a single organism with two heads, two hearts, four legs and arms - or is that single org"

I once was present in the labour room when a child was born with two heads - yes two heads - on a single set of enlarged shoulders. conjoined twins or just another major abnormality? So then. you can't label all conjoined twins the same. There are huge variations in the degree of joining. Some are born with two bodies and one head for example.

In the case above, the two headed child / conjoined twins was / were stillborn. But what if it / they had stayed alive? What if we had landed up with two thoughtful conjoined twin brains on the same body - perhaps only one actually in control of movements below the neck?

Strangely enough, a surgeon has made an artificial conjoined twin of a monkey, onto which a second head was transplanted. (See video).

The moral debate on separation of conjoined twins

In fact the situation with the conjoined twins in the UK was in a way quite similar. Although at first sight each appeared to have a separate well formed body with some joining at the lower body, detailed tests showed these conjoined twins were very unequal - one was providing the heart, lungs and many other basic functions.

The other conjoined twin was very poorly equipped for separate life. To make matters worse, these conjoined twins, Jodie and Mary, were also to some extent mutually dependent. If separated, the stronger and more capable conjoined twin (Jodie) would need huge amounts of surgery over subsequent years, and was likely to suffer significant handicap.

The parents came in a hurry to the UK because they heard that Britain was expert on the management of conjoined twins, hoping no doubt that both could be separated with few long term problems. The long court battle was decided with doctors being given the right to cut off the weaker conjoined twin, thereby killing Mary, to preserve the life of Jodie - against the parent's wishes. They felt that if the two could not be safely separated then they should be left together and nursed with loving care until natural events took over. Some doctors said that both would soon be dead in that case. Others said that these two conjoined twins could survive far longer with good basic care.

Doctors have second thoughts on separation of conjoined twins

Of course, once the court battle was won by doctors, they began to have second thoughts. It is a brave doctor indeed who is willing to take the knife to two conjoined twins, both of which are at that point alive and growing, and see perhaps both conjoined twins die in the operating theatre or very shortly afterwards. Easier to go ahead if the parents want their conjoined twins separated and understand and accept the risks - but what if you have had to force the whole thing on them in the first place?

And there is another issue. The survivor of these conjoined twins would need huge care efforts and community support. The parents said this was unlikely in their own culture.

A fundamental problem in conjoined twin decisions is that the parents themselves may not always agree, they may each feel differently on different days. It is common for parents to feel somehow that the birth of conjoined twins is their fault, or to blame each other, doctors, society or God. The natural joy of birth has been replaced by overwhelming grief for the loss of what might have been - in this case one or two perfectly normal children. This is a hard place to make life-changing decisions about conjoined twins management.

Doctors should treat with great care

My own view, on balance is that doctors should tread with great care when parents are refusing certain treatments for their children, where the outcome of successful treatment is likely to be severe handicap and loss of quality of life. It is a human right for any human being to refuse medical treatment, and it is the responsibility in the case of children for parents to take those decisions on behalf of their children. In this case the fight was because some doctors disagreed with the parents and wanted to take that responsibility away.

But these parents had come to the UK in good faith, seeking advice on the management of conjoined twins. They did not expect to find themselves imprisoned in the country, forbidden to take their children back home, and forced to take that advice, when they believed it to be morally wrong. Their conjoined children were essentially kidnapped by court, and imprisoned against their parents' will in the UK. That does not sit comfortably with me.

Medicine gone mad

Too many times I have seen medicine gone stark raving lunatic mad with aggressive over-treatment and stupid decisions. Even the Catholic church, traditionally the most conservative in these matters, has taken the position that doctors should not strive officiously to keep someone alive. This is a common issue in the care of those dying of advanced cancer. It was in keeping with this that the Vatican offered a safe refuge and hospice care.

Here is a strange irony: if mother had arrived a day before going into labour, under existing UK law doctors could have killed the conjoined twins in the womb and then forced a labour and buried or cremated them without any fuss whatsoever. The UK has one of the laxest abortion laws in the world. But the moment these two conjoined twins were born, the world began to worry that every possible effort should be used to at least keep one alive.

It would be far safer for the future of humanity if we meddled less, and allowed nature far more room to take its own course, neither slaughtering babies in the womb just hours or minutes before birth, nor going over the top to fight for life at all possible costs after birth.

* The Siamese name often used for conjoined twins comes from the well known twins Eng and Chang born to Chinese parents in Siam (now Thailand). The first surgical separation of Siamese twins was in 1953.

February 06, 2004

We can debate the morality and chaotic aftermath of the 2003 Iraq War, and miss the bigger picture, which is far wider than the post 9/11 war against terror, or the current crisis among Palestinians and Israelis, or the situation in Afghanistan, Saudi Arabia, North Korea, or the convulsions in the UN and the EU, or US global dominance and accusations of aggressive imperialism.

The problem of the global village - and the truth about the Iraq war

Here is a simple but fundamental question, which was at the heart of the Iraq war controversy: how is the global village to run and be governed? It’s the hidden basis of the political conflicts in the UN over Iraq and similar issues.

The inescapable fact is that we are moving further every day to a one–world economy without a one–world government or legal structure.

Last-century thinking describes a world of nation states, where national sovereignty is absolute and cannot be violated under international law except to resist aggression and in self-defence. That was the French and German position on the war with Iraq and it has very powerful historical precedent.

But life has moved on. We will need a new model altogether if we are to live in prosperity and peace during the third millennium. That’s because at least 4 billion people are already living in towns, cities or rural areas which are profoundly affected by globalisation and the techno-communication revolution. They are already citizens of the global village, or the global nation of all nations.

The start of a new world order began with war in Iraq

Since the collapse of Communism we have seen the beginnings of a new world order: all nations working together in a semi-democratic global body to seek the common good, for the whole of humanity. It may be primitive and rather innefective, but is becoming more significant.

In the last decade the UN has grown in stature from a feeble committee weakened by bickering, paralysed by a tiny minority of countries who had the right of veto. The UN has become a stronger unifying force in world affairs. That’s why sharp debates over how to discipline Iraq’s government have been all the more shocking.

But don’t be misled by aggressive speeches: when you think back to the days of the Cold War, the consensus amongst developed nations in early 2003 for some kind of significant UN intervention in Iraq’s affairs was overwhelming by historical standards, although you would have been forgiven for thinking the opposite from the media coverage of UN voting intentions.

Lesson from the Cold War

During the Cold War, any threat of military invasion of a country by Russia or America would have produced in most cases immediate counter-threats by the other. As a result most wars were waged by proxy in far away places, between small nations funded and armed by both superpowers.

But in March 2003, despite all the hot air, not one nation in the world offered to fight for Sadam and protect Iraq from American invasion, least of all Russia or China. Not one other national army offered soldiers or weapons to protect Iraq national sovereignty, to liberate the people of Bagdad from foreign US-dominated forces, to underpin survival of the Sadam regime.

Sure, some nations held back, abstaining, remaining neutral. Some national leaders were making strong statements of protest - but these turned out to be only words, not backed by bullets. Where were the countries lining up to sell hundreds of high-tech missiles or tanks or planes to Iraq?

So the strange reality is that while it appears at first sight that the new fragile world order is crumbling into the dust, the opposite may be the case. Of course much depend on how Iraq instabily settles or flares, the early and "successful" withdrawal of US and other foreign troops, life for the Iraqi people post-withdrawal, and the impact on the region as a whole.

The current tensions and conflicts may well fuel further waves of terrorism, especially if the US fails to take a powerful lead, together with international support, to help establish a “just” Middle East peace settlement for both Palestinians and Israelis. It may also lead to destabilising regime changes in other Arab nations, replacing family dynasties with anti-American Islamic fundamentalism in countries like Saudi Arabia. But the current spats are unlikely to lead to destruction of the UN, nor the break up of the EU, nor the rapid neutering of American power - quite the opposite.

The world is far more united than words suggest

The truth is that most nations of the world united in condemnation of Iraq’s invasion of Kuwait, and again in imposing sanctions of many kinds over more than a decade since. They united again post-9/11 in a coalition against terror and more recently in insisting that UN-monitored disarmament took place.

When it came to discussions about weapons inspections and the threat of armed intervention, disagreement was almost entirely over process rather than substance: how disarmament should be achieved, measured, monitored and if necessary imposed, and over what timescale? At what point should the international community conclude that all alternatives to armed intervention have been exhausted? What form should military intervention take under such circumstances? How should it be led and financed? How should the peace be kept, reconstruction proceed and national autonomy be re-established?

Our memories are short. The level of multinational consensus about the need if necessary to intervene in the affairs of rogue states is extraordinary and unusual in world history.

That is why there is such a consensus about Iran now amongst France, Germany, Russia, UK, US, China, India and many other less powerful nations about the need for the international community to act by force if necessary, if Iran continues despite many warnings with an active programme to rapidly develop nuclear warheads.

And so we return to the global village – or rather the global nation of all humanity.

Economically, the world is already operating as a single closely inter-related organism. The problem is that mechanisms for governance, law and order are still primitive – feudal or medieval in nature. We have yet to grow up.

So we have “cities” in the global nation behaving like little kingdoms, taking the law into their own hands whenever it suits them (Russia and America), while at other times appealing to the “government” to impose common will on others.

What of the future? Life after the Iraq war will never be the same

Expect the world-wide love-hate relationship with America to become even more polarised, on the one hand hungrily devouring American media culture, on the other hand increasingly bitter and resentful at American power and lack of sensitivity to how the rest of the world works.

Expect new generations of terrorists to take courage and exact “revenge”, with the aim of “wounding American pride and arrogance”. Every one of them will tell you they are fighting for a higher moral cause.

Expect America to continue to feel deeply hurt, increasingly isolated and angry, the target of frequent terror attacks and general animosity in many places, acting forcefully around the world wherever it feels national interests dictate, and withdrawing to lick its wounds when it does not.

Expect America to be increasingly hostile to the idea of submitting in any respect whatsoever to the will of the global majority, whether on the environment, trade agreements or any other matter, and to be in even less mood to compromise than pre-Iraq War. Expect the US at the same time to make intensive diplomatic efforts to try to win back lost friends, but with ever-deepening suspicion of UN controls, inefficiency, corruption and influence.

In contrast, expect almost the entire rest of the world to invest intensively in the UN as the sole vehicle for solving complex international issues, in a quest to create a more sustainable and peaceful future.

Expect the EU to forge ahead with renewed energy to create structures to balance US power economically and militarily. But the EU will be severely restrained by ongoing internal conflicts, which will be made worse by every new country joining, as well as by unfolding events. Expect the UK to be frozen out of significant decisions by France and Germany who will seize every chance to dominate the future of the EU together, and to humiliate the US. Expect UK doubts to grow about whether it will ever sit comfortably within a Franco-German led federation of EU states. Expect France and Germany to be increasingly worried about rapid enlargement, and dilution of their power by pro-US nations with shaky economies, arguing passionately that the world will be a better place if there is a significant European counter-balance to the US.

Expect several non-European nations to embark on dangerous military adventures, arguing that the US has set a new model for them to copy: “legally” invading other countries when they could possibly be a future threat. India and Pakistan, North and South Korea and so on. These local wars could produce huge problems for the future stability of the world. Expect concerns about this to lead to calls for stronger structures and processes within the UN.

Reforming the UN as a more democratic global authority

A key challenge will be to reform the UN so that it can become more effective and fair as a federation of nations. The current powers of veto are anti-democratic and smack of nineteenth tyranny, held as they are by very few supremely powerful, wealthy nations,

The UN will only carry true global moral authority when each nation is able to cast votes in proportion to it’s contribution to global population, so that each citizen is represented equally without fear or favour. But this is an unthinkable prospect.

Even an idea of such a global assembly will provoke huge reactions in wealthy nations, because it strikes to the root of the most important unsolved problem on the planet today: the fact that most people are extremely poor, with no voice and no vote in world affairs, living off less than $2 a day.

Why global democracy is so unpopular

And so we find an interesting fact: those who live in democratic nations, who uphold democracy as the only honourable form of government, are not really true democrats after all. They have little or no interest in global democracy, in a nation of nations, in seeking the common good of the whole of humanity.

And it is this single fact, more than any other, this inequality of wealth and privilege in our shrinking global village, that will make it more likely that our future is dominate by terror groups, freedom fighters, justice-seekers, hell-raisers, protestors and violent agitators.

The lesson of history is that tyrannies and dictatorships get overthrown, that the will of the majority eventually finds a voice and freedom.

And that is exactly what will eventually happen in our non-democratic, dysfunctional, unjust, global village.

We cannot wind back the clock

We cannot wind the clock back fifty years to a cosy world where these country by country contrasts no longer matter. CNN and Hollywood have seen to that.

On TV screens in the poorest slums on earth, millions of people see their wealthy neighbours go about their daily lives while they scrabble in the dust to find money for basic food and shelter. They have seen the truth.

The digital society created the global village and globalisation the basic rules for trading within it, but neither has taught us how to live together in such a small cultural space. This is the greatest moral challenge of our time.

In a future world where small numbers of activists will wield unimagineable power with dirty bombs, nuclear devices, chemical weapons and strange viruses, our very survival will depend on finding a way to live together in harmony, with freedom and justice for all.

And that will require further extrensions of global governance.

History may record that it took us many decades, possibly, to agree to it – but what will be the pain along the way?

February 05, 2004

Many CEOs I know are feeling battered and bruised right now. Hit by one event after another, there's little time to regroup or reflect, and the top of a corporation can be a lonely place. Profit warnings, share price pressures, painful layoffs and great geopolitical uncertainties can sweep away even the most comprehensive strategies - and that's despite outstanding management over many years. (This article was published in Leigh Advisor June 2002)

It's easy to lose sight of the bigger picture in the rush to cut cost and conserve cash. Hopefully you succeed in protecting the business, satisfying shareholders and analysts, but what about morale and momentum in the senior team?

To be a winner in the next three years you need to use the downturn to reshape for growth, propelled by an unshakeable conviction that your mission is still important, that more prosperous times lie ahead, and that in some way your company is helping to build a better kind of world. Your own passion for running the race matters most of all in a downturn when people are insecure and loyalty is tested.

Your corporation's future will be dominated by six factors, or faces of a cube, spelling F U T U R E. So if you are going to cut, then cut carefully for healthy fresh growth, and take the rest of the workforce with you with a renewed sense of direction. And what direction is that?

Fast: The world is changing faster than boards can think, so survival means scenario planning as far as possible before events happen, with rapid response plans, making every dollar count. Market research can't predict the future in a rapidly changing world - it just shows what consumers think. We "

February 02, 2004

Why current obsession with "bottom-line profit" and "shareholder value" is looking tired: having failed to help leadership, motivation, marketing, product innovation, change management, or customer loyalty - danger of destroying the value that people sought to gain

You can have the greatest strategy in the world but if your vision of the future is wrong you just land up travelling even faster in the wrong direction. A prime example of this is the dangerous obsession with shareholder value and bottom line profit, which has driven board policies of many multinationals to the point of distraction and damage.

* Dr Patrick Dixon is Chairman of Global Change Ltd, a regular contributor to Business School executive programmes, and has recently been ranked as one of the fifty most influential business thinkers alive today (Thinkers50.com).

The language in some corporations is already changing. "Shareholder value" is being retired from such places as corporate websites. Expect further steps in this direction over the next three to five years.

1) Shareholder value has failed to motivate boards or staff

"Shareholder value" has been a useful emphasis for companies which were insufficiently focussed on profit-making, cost-reduction and share price, particularly in a difficult economic climate where falls in share prices can lead rapidly to a hostile takeover. We have seen a number of events where wrong decisions have destroyed vast amounts of wealth in a short time, so many have argued that more attention to shareholder value is needed, not less.

But "shareholder value" implies that shares themselves have a "value" which has a rational basis. As we saw in the dot com boom and bust, and on many other occaisions, this is often not the case. On the contrary, we have witnessed an increasingly fickle and restless market, which has imposed near-impossible demands on boards to produce perfect results every quarter, resulting in very short-term thinking by executives.

Many CEOs have been acutely frustrated to find their well-crafted strategies swept away by alarming share price wobbles, each an over-reaction to some small piece of news about their own company or a competitor, or the industry or wider operating environment. "Our current share price makes no sense" is a common cry.

Too high a price can be just as damaging as under-valuation, because when the inevitable correction comes, the CEO can be hammered in the media for "destroying shareholder value" with "billions wiped off the value of the corporation in just a few months". The reality may be that the market over-priced, and is now under-pricing. Nothing much has changed in the meantime in the fundamentals of the business.

In any event, the outcome of prolonged turbullence is often the rapid departure of a Chairman or CEO who may in fact be a stronger and more experienced leader than the person dragged in at high speed to replace them.

It is all a question of perception.

A further complication is that CEOs are finding it increasingly difficult to know who their shareholders really are. The average share owned by an individual in the US is kept for just weeks or months. Churn has never been higher. Institutions are also constantly changing the balance of their investments, buying and dumping proportions of the same stocks on a daily basis.

The end result of all this is that every corporate strategy tends now to be accepted or rejected according to how the board thinks the market will react, and the market reacts how investors think other investors will react - based more on psychology, mood, emotion and intuition than pure logic or longer term conviction. Because investment funds often hold such large percentages of total shares, many CEOs are having to spend huge amounts of time trying to persuade a few individuals inside these institutions that they know what they are doing, and that the share price will rise.

I have sat in many internal presentations by CEOs to their own top teams, where they have laid out goals such as "increasing market capitalisation by 35% in three years" and so on. Even in a rising market such word and number games looked faintly ridiculous, since achieving such goals usually depends on a number of external factors such as competitor merger and acquisition activity. But in a falling market these kind of targets make a previously confident CEO the laughing stock of the corporation, and of the investment community. How do you measure shareholder value in a recession?

In the recent down-turn, many companies resorted to ever more complex graphs, formulae and tables to show how their own market capitalisation had fallen less than a benchmark of a carefully selected group of competitors. But every business is unique, particularly in these days of aggressive globalisation and multiple business units, so such comparisons can be superficial and naive.

"Underperforming" or "outperforming" are at the end very difficult judgments, which unfortunately are often muddled by short-termism. The most important assets of many companies are notoriously hard to value: for example the creative brain-power of a very talented new senior team, or a pipeline of products for a pharma company, none of which will come on-stream for a decade or more, or the future potential of a group of wealthy clients for cross-selling a new product range, or the good-will and respect at the highest levels of the government in China and so on.

You may disagree: you may consider yourself a great expert on corporate valuations and assessing corporate performance, but there is another, more fundamental problem. The trouble is that "shareholder value" (even if it can be reliably measured) cannot by itself as a concept create value. Nor can it create vision, nor direction, nor purpose, nor a sense of mission.

"Shareholder value" as a concept does not invent products, neither does it promote initiative, nor create ideas about new services. Nor does it inspire people to greater efficiency, especially when those efficiencies may come at inconvenience and cost to themselves or those they care about. For these and a host of other reason, by definition "shareholder value" cannot drive a business forward.

In fact the very opposite.

As we will see, "shareholder value" on it's own is a morally bankrupt, narrow idea that took root in investor minds, and then became the latest fad as a mindless, meaningless, last-century business mantra, chanted in unison by millions of senior executives around the world, despite the fact that those same executives were already bored to death by it.

Morally bankrupt because the only obligation in such a narrow business philosophy is to those owning the corporation. Obligations to treat customers well, or staff fairly, to care for community and environment, are seen only through the lens of how such activities add or detract from "shareholder value". Such corporations have been rightly condemned by the public as having no heart, as being amoral, interested only in profit, ready to break the law, bend the rules, exploit the vulnerable, if the end result is higher dividends and share prices.

The current focus on corporate ethics is because our society is coming to recognise that trying to build "shareholder value" without strong ethical values is a complete nonsense.

In any case, "shareholder value" is a useless motivator. Who on earth wakes up in the morning and thinks: "What a great day - let's go and make some extra sharholder value, let's make some more dividends and make the share price soar?"

No one I have ever come across in corporate boards, executive teams or business school classrooms - unless it is their own personal startup or family business.

Executives are focussing today on other things, and the trend is becoming stronger. Just look at the growing number of people who are worried about their lack of work-life balance (almost 100% of every executive audience I have ever polled). Consider also those who are talking about down-sizing, turning down promotion, taking pay cuts. This is new. Different from the 1980s and early 1990s.

Look for a moment at those who are more passionate about the work they do for nothing (volunteering) than about their "jobs". Over 60% of Americans last year gave time to their communities - on average around 200 hours each - and the numbers are not much less in many other nations. But tell me this: who on earth "gives time" for no other reason than to make extra shareholder value for someone else? Who wants to go an extra mile for an employer just for that?

Take a global bank: who cares about making even greater profits for other people at year end? That is, unless their own job or bonus is at stake.

"Shareholder value" is becoming thoroughly discredited as a dominant business driver. Expect an even greater backlash followed by a major rethink across all industries by 2010. "Shareholder value" business gurus will be kicked out of corporate boardrooms, heavily criticised and held up to public ridicule - unless they change their message soon. It may happen faster than you think. Like waking from a deep sleep, the moment of recognition can strike a hard-pressed CEO in a moment.

I have rarely met a CEO or Chairman (perhaps never) of a publicly listed company who is trully passionate about either shareholder value or bottom line profit, or what the market thinks - compared to the passion they express when they talk about their families, the work they do for nothing in the community, or other things they believe in. A possible exception is where the company was started and taken to market by the individual.

This lack of passion and personal commitment is hardly a surprise when you consider that the average survival in post of a Footsie 100 company chairman or CEO before being sacked is just 38 months. That means many are told to go far sooner than that - maybe because they failed to make their numbers for a couple of consecutive quarters. But if CEOs have no real passion for shareholder value, don't expect it further down the feeding chain.

Corporate investors show zero emotional commitment to company leaders in times of trouble, so don't expect emotional commitment by their leaders to the future shareholder value or profits of the corporation - unless merely as an expression of naked self-interest with their personal financial rewards linked to share price and so on.

2) It is factually incorrect to say that the only purpose of a corporation is to make shareholders wealthy

I am not for a moment suggesting that corporations should abandon a healthy interest in profitability and an aim to reward investors. However, some who have learned their last-century script from certain business schools or books, or have been infected by similar nonsense from colleagues, proclaim that the only possible purpose a business can have is to make money for the owners.

This is not only a very foolish position to take when marketing or building a loyal customer base, but is also factually incorrect, as a moment's common-sense reveals. We see the paradox revealed when marketing messages reach investors and the other way round. They are not the same and are often in conflct. In the past one could keep messages separate but in a web-enabled world they collide in embarrassing and counter-productive ways.

Marketing: we are here to serve you as a valued customer

Investor: we are here to make money out of customers to give to you

Many corporations are in trouble over this conflict right now.

Take an life insurance company: try telling policy holders that the only purpose of the company is to charge the largest amount possible given competitive pressures, to pay staff as little as possible, to pay out the absolute minimum to those who die, and to rip as much wealth out of the business as possible to give to shareholders.

Sadly that is not so far from the public perception of the insurance industry in general - and is what you get if you follow the "shareholder value" mantra to an ultimate extreme, and are overheard in public places.

But nothing could be further from the truth.

A life insurance company exists for only one reason, and was created for that purpose: to pay out... to families in the "club" who are in trouble because their relatives have died. Allied to that is a secondary purpose which is to enable members of the club to sleep at night, knowing that if disaster strikes, financial help will be available from pooled resources that the club has collected in the past. All insurance companies are collective community-based organisations which are run to share risk.

shareholders? Yes, capital is raised in the market, to expand and develop the number and range of such clubs, and those shareholders are rewarded for their help with dividends and capital growth. But you cannot drive a successful insurance company for long if you only talk about rewarding shareholders. It can only be a matter of time before you kill the business.

But insurance companies are not unusual: all businesses exist to satisfy the requirements of their customers - in a mutually rewarding and profitable way.

Lost the plot

Senior team members of many different corporations in different business sectors tell me things like: our staff are not passionate about the strategic objectives we have; our turnover is higher than we would like; our customers say that our call-centre staff don't seem to care; our sales team is demoralised and our rewards programme is not getting expected results; the image of our industry is not what we would like; people say we are greedy, they talk of fat-cat salaries, exploitation and so on....

But that is what you are likely to get when all people feel matters is making numbers on Excell spreadsheets. And incidentally, they may suspect that however outstanding last year's performance may be, the bar will always be set ever higher.

Imagine a restaurant where it says on the menu:

"We exist to make make a profit out of feeding you"

"This restaurant exists to make as much money every week for me, the owner, as I can possibly extract. That's why we always use lower cost ingredients where we can get away with it, pay staff a pittance, spend the minimum on cleaning the kitchens, and charge as much as we can persuade you to pay."

It would be out of business in a couple of months. Customers want a different kind of service. The want to feel that the whole focus of the restaurant is to give people a great eating experience in a wonderful environment. They want to feel that the owner really cares how the food is prepared and takes great personal pleasure and pride in every aspect of menu creation, is hospitable by nature and enjoys giving people a great time - not that he hates the restaurant and the people in it, would stop tomorrow if he could, and only does it for the money. It may be partly a fantasy, but they want to feel it is a reality.

3) How to motivate, encourage and inspire

Stop talking so much about shareholder value. Start talking to people about the people who buy things from you : who they are, what they want, why what you do makes a difference to other people's lives (if you can't answer that, get out now, life's too short, time to find another job), and finally why you feel your corporate mission is so important.

Focus on customers, meeting their needs, delighting them time after time with outstanding products and services, which you are able to provide in a profitable, sustainable and enjoyable way.

That's always been the basis of every business that has prospered.

"We are here for you" - not " We're only in this for the money."

Sadly, the morally empty obsession with shareholder value has encouraged a culture of greed, and an orgy of corporate excess, creating a the right conditions for a host of corporate scandals.

Future consumers will demand that success be measured on a far wider agenda.

Connect with all the passions people have and they will follow you to the ends of the earth, buy your products and services with pride and may even be willing to work with you for next to nothing.

The fundamental requirement for future corporations will be to demonstrate how you build a better world in a broader sense: not just for shareholders, but also for customers, consumers, colleagues and communities as well as for yourself and those you care for.

January 31, 2004

See this online book on British political life - and how so many people with integrity can find themselves altered - corrupted even, albeit in subtle ways - by the process of government and the pressures of office. Relevant to posting below, on the battle between media and politicians, based on a morally dubious pattern which tends to polarise and exaggerate party differences, in order to try to gain added public attention or audience.

In December I spoke to around 100 of the most senior people at the BBC about their future, and future of broadcasting / journalism in general.

There is a huge crisis of confidence in both politicians and journalists which is undermining our democratic process, with falling interest in political debate, manifestos or election voting.

A primary reason is that most people believe that politicians are insincere, and that journalists exaggerate to make a story.

In my own experience of the media (audience reach over 200 million in the last 12 months on various interviews - see medialog) there is constant pressure to fill papers and programmes, because or a lack of enough real news.

The gap is filled by debate and conflict between individuals. However there is not enough of that either, so it is often hyped or even invented.

I have lost track of the number of times over the years I have been phoned to appear on a TV or radio programme, and it has been made absolutely clear that they are looking for highly coloured views. If they think that one's views are likely to reflect those of the middle majority, they are keen to proceed if it a general comment piece, but if it is a debate they tend to drop the idea of an interview with me and start pumping me for the phone numbers of people who have a more extreme position (it makes better TV).

Frequently I have found myself in a one-to-one interview being invited on-air to criticise what someone else has said in a previous interview. On many occaisions that person's own words are re-positioned to give a superficial characture of their actual position. I know for a fact that has also happened immediately after I have left a studio.

It also happens in the press. A journalist trying to stir up a fight may phone to suggest that an individual I know has said a particular thing, sharply critical of what I am saying on an issue. A time to take care. A quick call to the person concerned or a reading of their own press release often makes it abundantly clear that their own position has been deliberately distorted.

The truth is that most people agree on most things in most Western countries and this is especially true in the UK.

Most politicians also agree on most things.

Tony Blair and Michael Howard agree in private on most things. That is an inescapable fact. We know that whoever was in power over the next three years, very little would actually change.

The truth is that ministers try to do their best, but have very limited influence. Their job is difficult and complex: they are also very dependent on advice they receive (which can be wrong). Many decisions are dictated by Brussels, much of the rest is decentralised. Yet other decisions were inherited by a previous government. Most other parts of traditional government have been privatised. What little that remains is run by a civil service that endures from one government to another, comprising of (in the main) experienced and competent people who maintain stability and continuity through all the fads and fashions of political policy experiments.

New governments very rarely reverse legislation when they get into power - however bitterly at the time they have pretended to be opposed.

There is a collusion between politicians and the media, both of which have a strong interest in exaggerating differences. For the media it makes interesting copy (they think) or rivetting viewing (they hope). For politicians it gives them exposure and (they fantasise) makes people see them as different from the other side so they win support.

This offensive and melodramatic drama is played out every day in the public media theatre.

It looks awful, is very tedious and boring, invites ridicule and cynicism, damages broadcasters and politicians alike, destroys ratings, contributes to the decline in audiences for current affairs and news programmes, makes a rising generation disinclined to enter politics at all.

After all the virulent criticism of Lord Hutton, the BBC has on opportunity to lead our nation in a more mature political debate.

The BBC, along with all news outlets, must learn to tell the truth - and force politicians to admit the reality.

The truth is that in Select Committees different parties work very happily and harmoniously together for the good of the nation. That MPS seem to undergo a personality refit when elevated to the House of Lords, leaving the infantile rough and tumble of party-poltiical posturing in the dustbin where it belongs. That most MPs have very good friends in the other parties. That many MPs agree more with MPs in other parties over a number of issues than they do with their own leadership. That there is overhwelming agreement on the fundamentals about how the economy should be managed, the need for social welfare as well as vibrant free-market economy which is friendly to business, a cautious view of entry to the Euro-zone, and so on.

The alternative is to continue with the current madness, which is such a distortion of reality. Failure to bring a culture change will result in further destruction of public confidence in both politicians and the media, and will risk further misjudgments such as that which led to the Hutton enquiry.

January 29, 2004

Interesting discussions with two different clients today about the death of shareholder value as a single driver of business targets to the exclusion of all else.

As I have been predicting for some time, the language of shareholder value is changing, softening on websites, in annual reports and internal communications in Europe, tempered by one scandal after another in companies which focussed on narrow definitions of success and corporate duty.

It is absued nonsense to try to build a business on giving shareholders loads of rewards. The core of every successful business is providing customers what they want, in a profitable way - a rather different emphasis.

I cannot understand how apparently intelligent and experienced executives could possibly see otherwise.

Satisfied customers must be a first priority and focus. Placing shareholders first in the feeding chain creates a culture where executives are tempted to cut corners, short-change customers. You cannot allow pressure from shareholders to suck the business dry.

January 26, 2004

RFIDs - the new techno revolution

I met today someone whose company (Alien Inc) has a machine the size of a small room able to make 10 billion Radio Frequency Identification Tags - or radio barcodes - in a year. Ten of these machines could provide 100 billion tags a year. Since Wal-Mart alone will need 5 billion just to tag pallets and boxes, it is clear the market is going to grow fast and prices will tumble - perhaps reaching as low as 3.5 cents per device. The technology is ingenious. I have in my pocket 100 chips in a small bottle. These automatically find their way in solution into identically shaped slots in a plastic membrane where they become permanently attached, so that they can be separated, and mounted onto a piece of paper on which is printed an aerial in special metallic ink. They are then fully active with hardware, software, permanent memory, operating system, and ability to write and receive data. It all happens more or less without human intervention using huge silicon wafers, and wide sheets of special laminates and papers which are then cut up to make each tag.

See presentation I gave today in London on RFID technology and security / privacy issues RFID SLIDES

“I don’t understand it. We’ve offered him a bonus of half a million dollars to stay on – and he’s still set on leaving.” The key was what he wanted to do instead – without being paid a single cent.

(A shortened version of this article appeared as a Unisys advertorial in the Economist on 13th September 2003.)

Ask your colleagues about the work they do for nothing and you may be shocked. You could learn more about them in three minutes than in the last three years working together. At most executive conferences I ask the audience the same question: how many people have given time to work for nothing in the last year for a cause you really believe in? And almost without exception, in every nation, there’s a forest of hands. Volunteering is a rapidly growing phenomenon, a common passion even amongst the busiest executives, and a vital issue for corporations to understand.

And what is even more interesting than to find out “what” is to ask “why”? Time and again you will hear moving accounts of people on a journey: a family tragedy, a friendship with someone who started a new community programme, meeting someone in desperate need, wanting to participate in activities that support the children – and so on.

Conference halls light up as people begin telling their own stories: real heart-filled accounts of time and energy poured out into situations that need help. I have never ever witnessed anything remotely like it, in any discussion of marketing campaigns, business challenges, management successes, product failures, financial objectives, operational plans or strategic targets. Actually, there is just one exception: you can often find the same in non-profits, where a high percentage of workers are unpaid, or working for very little financial reward, with a sense of personal vocation, on a mission to make someone’s world somewhere a better place.

There’s a crisis of motivation at work, as shown by a fortune spent every year on the latest management fad, books, videos, conferences and internal programmes. At the same time, many people have this intense drive, when touched in the right way, to work for absolutely nothing,

These community involvements by executives in corporations are often private, usually result from a personal story, and can be hard to talk about, but lessons from non-profit activity should be on the agenda of every executive board, not least because it means far more to many directors than the profit-focussed businesses they run.

Around six out of ten adults in the US now work without pay in any year for causes they believe in. The average volunteer gives 200 hours annually, contributing the equivalent of 4.5% of American GDP. In Europe the figures are lower but still substantial. Take the UK for example where 43% of adults give time each year, worth £40bn or 4% of GDP.

But there’s a problem with paid work. I have rarely met a Chairman or CEO of a publicly listed corporation who is truly passionate about shareholder value, bottom-line profit or return on equity – compared to the passion they express about their children, or community causes they are involved in, or whatever else they give energy to outside of the business. Strange then that that board members should think that anyone else will be deeply inspired by a vision of making their numbers every quarter.

Who cares?

You cannot expect a CEO to have true passion about a corporation when the average length of service before being sacked or pushed out is little more than three years in the UK and similarly short elsewhere. If you don’t make your numbers for three successive quarters you could be on the way out. The corporation has almost zero commitment to the individual, so it is unrealistic to expect the individual to lay down his or her life for the corporation.

This volunteering desire is all part of the same radical rethink about life that has also focussed on work-life balance, corporate ethics, corporate governance and social responsibility, and reflects the spirit of a new age, a spirit that will become essential for future business survival.

Last-century success meant making big profits for shareholders, with few questions asked. Real success in future will be far more difficult to define. It will mean demonstrating how your corporation makes a real difference for everyone: for shareholders of course, but also for your customers, and your workers, for the wider community, and in some small way for the whole of humanity – for example by protecting the environment.

Many corporations are still driving their strategies by profit considerations alone, with minor concessions to what they see as necessary requirements such as corporate governance, environmental protection or social responsibility. This narrow philosophy can be disastrous, as Nestle found recently when they tried to recover a few million dollars of old debt from a nation of starving Ethiopians, or embarrassing and damaging, as the pharmaceutical industry discovered, when they were forced by public outrage to permit “illegal” manufacturing of low-cost life-saving generic drugs by the poorest nations.

So what of the future? Expect more corporations to start adopting some of the language, culture and characteristics of nonprofits, while nonprofits will continue to make huge efforts to become more business-like. Between these two the public sector will struggle to compete with either the passion found in single-issue nonprofits, or the efficiency of corporations. Expect well-run nonprofits, led by spiritual refugees from corporate life, to seize a growing share of government contracts, especially in health care and education, and to attract huge talent.

Non-profits are a growing part of the UK and US economies and can have significant advantages because their mission is pure and simple: “We exist only to help those in need of our services. We do not exist to make profits for shareholders and all the surplus we make is ploughed back into developing even better services in the future.” However, the down-side is a reputation outside of the commercial environment for inefficiency, sloppy management, restrictive practices and resistance to change.

Connect with all the passions people have and they will follow you to the ends of the earth, they will buy your products and services with pride and often work for next to nothing. That is the secret of the voluntary sector. Business has a lot to learn. But so do non-profits and public sector groups – about being more focussed, efficient and future-orientated.

ACTION STEPS FOR PUBLIC SECTOR and NON-PROFITS:

• Make sure your mission is clear and attractive• Communicate with passion and integrity• Show how your organisation builds a better world for everyone• Prove that you are as well managed as the best businessesBenchmark against best-practice in commercial organisationso Implement radical changes where needed to reach commercial levels of efficiency• Explain how your non-profit motivation makes you differento No shareholders to satisfyo Total focus on those who need your help• Make sure your people are proud of the work you all do• Help your teams see how they make a real difference to people’s liveso Get people close to where the action iso Regular exposure to what the organisation is all about? Eg Private hospital administrators spend time with patients• Live your message and your mission!

LESSONS FOR CORPORATES:

• Take personal passion seriously• Make sure you understand what your staff and customers feel most strongly about – outside of your business, and harness that energy - for change and productivity• Show how you make a real difference because of what you do• Show how your business builds a better world for everyone - Customers, Shareholders, Workers and their familie, Community, Wider humanity• Encourage volunteering and community involvement• Make sure your people are proud of the corporation - What you do, How you do it• Turn your mission statement into a daily reality

(Presentation by Dr Patrick Dixon at national UK conference on RFID use - January 2004)

Get ready for the biggest manufacturing, distribution and retail revolution since the net. The next ten years will see a new techno-revolution which will allow total automation from manufacturing to point of purchase, using wireless technology.

A world, where everything that moves can talk to everyone, everywhere all the time. That means cartons of milk, bottles of wine, clothes, wallets, tyres, cars, pets and people.

Electronic bar-codes embedded into billions of different things and organisms which have value, including animals and possibly some human beings - sending out radio signals about what they are, where they are, and possibly what they are doing or how their bodies are working.

These devices are tiny micro-computer systems which already cost as little as 15p, expected to fall to less than 3p by 2005. They are going to change all our lives, containing hardware, software, and permanent memory stores. They transmit and receive data and have their own built-in power generators which could in theory last up to 100 years. Activated by a high-intensity burst of electromagnetic radiation from a distance of less than two metres, the devices respond with short bursts of data.

So-called Radio Frequency Identification Devices (RFID) are already being introduced rapidly by chains such as WallMart for larger consignments. RFIDs have been around a long time. Since 1997 you'll have found the same technology in Ski passes in Switzerland , in Swatch watches, some of which can store credit, as well as more recently in London Underground electronic tickets.

Within the current decade more of these RFIDs will be made each year than there are people alive on earth. Once prices fall to less than 1p per tag, retail usage will explode with anything from 20 - 40 billion tagged products sold a year.

RFIDs mean that a retail outlet can watch goods going out of the door and know who is taking them, even which card to charge. RFIDs prevent theft, help guarantee quality, provide absolute 100% precision about what stock remains in the food store and when products are close to sell-by dates. RFIDs allow factory owners to watch products moving off the shelves in Shopping Malls the other side of the world, triggering automatic increases in production, extra transportation, as well as instant requests for more raw materials to the factory door.

RFIDs mean I can pay for products and services ranging from bottles of wine to travel tickets, using a card that never leaves my pocket. They mean an end to stock control, inventory audit, confusion about location of orders, mistakes in warehouse picking or delivery. RFIDs mean accurate and fair road-use charging, and traffic management - as well as car components such as tyres or brake pads which shout to the garage for help when they are nearing the end of their safety margin.

RFIDs will reduce waste, keep stock levels to the minimum, shorten lead times, and allow some retailers to slash prices by more than 20%, by eliminating cost at every level. Laundry tracking, ID cards for employee security and staff location inside offices, data for customer loyalty programmes (we know you bought another one of these yesterday so here's a special discount today), automated guided vehicles in assembly lines, automated airline baggage systems - use will be almost universal across all industries.

At the same time, expect huge emotive discussions about personal privacy, and data leakage, with demands that next-generation RFIDs contain a reliable switch which can be turned off by a consumer after a product is bought. Pressure groups will campaign successfully in some nations against data-leakage, where all kinds of information could theoretically be transmitted about an individual without their knowledge or consent, by tags in their shirts, shoes, gloves, belts, car seats, credit cards and so on, in response to unscrupulous use of scanners which could be as easy to conceal as mobile phones.

In theory RFIDs could enable me to read all the numbers and expiry information on the credit cards in your pocket as you walk by, as well as where you do most of your clothes shopping, and the model of the portable computer you are carrying in your briefcase.

It also enables me to track you (probably by what you are carrying or wearing) as you pass by from one scanner to another, not only in and out of buildings, but on and off trains, planes, in coffee shops and in supermarkets. Of course the technology already exists for this, using mobile phones. For a small fee you can already watch on your children or partner walking around the streets of London on a web-based location map using data provided by cell-phone companies.

Privacy is a major and very sensitive issue: one that has not been properly addressed by passive RFIDs so far - as a recent incident showed at an international conference where it transpired that all delegates were tagged without their knowledge or consent, using concealed RFIDs inside every badge.

We will also see a whole new crime industry built around theft identity - not just of people and their credit-worthiness, but also imitating the electronic signals of all kinds of products - for example disguising empty pallets, supposedly containing many thousands of pounds of pharmaceuticals. Virtual counterfeiting will mean freight loads travelling around the world that talk all the right electronic talk, but contain nothing but ballast inside.

So then, price-falls in technology will have to go hand-in-glove with tightened security measures or there will be a risk that ordinary men and women may decide that RFIDs do not, after all, promise them a better kind of world.

Take hold of the future or the future will take hold of you.

* Dr Patrick Dixon is Chairman of Global Change Ltd, author of Futurewise. He has recently been ranked as one of the 50 most influential business thinkers alive today (Thinkers50 / Bloomsbury Publishing). http://www.globalchange.com - 4 million unique visitors

For Times Feature by Dr Dixon on RFIDs and injectable devices in people and animals see "The office has got under my skin"